NDLI: Improved leg wound healing with endoscopic saphenous vein harvest in coronary artery bypass graft surgery: a prospective randomized study in Asian population.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Au, Wing Kuk Tim Chiu, Shiu Wah Sun, Man Ping Lam, Kwok Tai Lin, Ming Fai Chui, Wing Hung Yeung, Chung Lai Cheng, Lik Cheung
Spatial Coverage	Hong Kong
Description	Country affiliation: China Author Affiliation: Au WK ( Department of Surgery, Division of Cardiothoracic Surgery, Li Ka Shing Faculty of Medicine, University of Hong Kong, Grantham Hospital, Hong Kong SAR, China. auwkt@ha.org.hk)
Abstract	OBJECTIVE: Conventional open saphenous vein harvest (OVH) for coronary artery bypass graft surgery is often associated with significant pain and morbidity. This study aims to determine whether endoscopic saphenous vein harvest (EVH) reduces leg wound morbidity and improves patient satisfaction as compared to OVH in Asian population. METHODS: Between March 2005 and June 2006, 120 patients who underwent isolated CABG were prospectively randomized into EVH (n = 60) and OVH (n = 60) groups. VirtuoSaph (Terumo Cardiovascular Corp., Ann Arbor, MI, USA) harvesting system was used for EVH. We analyzed leg wound complications (ASEPSIS score), postoperative pain, satisfaction, and clinical outcomes. Fisher's exact test and Mann-Whitney U test were used for categorical and continuous variables analysis respectively. RESULTS: Six patients in the EVH group required conversion to open technique. Both groups had matched demographic characteristics and risk factors. Mean numbers of grafts performed were 3.2 +/- 0.6 (EVH n = 54) and 3.0 +/- 0.7 (OVH n = 60) (p = 0.03). ASEPSIS scores at postoperation days three, seven, and 21 were significantly lower in the EVH group than the OVH group (p = 0.02, p = 0.002 and p = 0.01, respectively). Wound pain scores at postoperative days three, seven, and 21 were significantly lower in the EVH group (p = 0.000, p = 0.001 and p = 0.000 respectively). Wound numbness was found in 5.7% of the EVH group and 33.3% of the OVH group patients (p = 0.01). [Six patients required conversion to open technique.] There was one hospital mortality (OVH group) and major postoperative complications were not significantly different between the groups. CONCLUSION: EVH system is a safe and effective alternative to OVH with better wound healing, reduced postoperative pain, and wound numbness. However, the higher conversion rate to OVH in Asian patients requires further evaluation.
File Format	HTM / HTML
ISSN	08860440
Issue Number	6
Volume Number	23
e-ISSN	15408191
Journal	Journal of Cardiac Surgery
Language	English
Publisher	Wiley
Publisher Date	2008-11-01
Publisher Place	United States
Access Restriction	Subscribed
Subject Keyword	Discipline Cardiology Discipline Surgery Coronary Artery Bypass Endoscopy Leg Saphenous Vein Transplantation Wound Healing Aged Asian Continental Ancestry Group Adverse Effects Female Health Status Indicators Hong Kong Humans Male Middle Aged Pain Measurement Pain, Postoperative Prevention & Control Patient Satisfaction Prospective Studies Clinical Trial Journal Article Randomized Controlled Trial
Content Type	Text
Resource Type	Article
Subject	Pulmonary and Respiratory Medicine Surgery Cardiology and Cardiovascular Medicine

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